Glucose Levels and Risk of Dementia
Presented by -
Anas Kabaha , MD
Sheba medical center
August 8,2013
Background
Diabetes is a risk factor for dementia. It is
unknown whether higher glucose level increase
the risk of dementia in people without diabetes.
Methods
We used 35,264 clinical measurements of
glucose levels and 10,208 measurements of
glycated hemoglobin levels from 2067 participants
without dementia to examine the relationship
between glucose levels and the risk of dementia.
Participants were from the Adult Changes in
Thought study and included 839 men and 1228
women whose mean age at baseline was 76
years; 232 participants had diabetes, and 1835
did not.
We fit Cox regression models, stratified
according to diabetes status and adjusted for
age, sex, study cohort, educational level, level
of exercise, blood pressure, and status with
respect to coronary and cerebrovascular
diseases, atrial fibrillation, smoking, and
treatment for hypertension .
Baseline Characteristics of the Study Participants.
Risk of Incident Dementia Associated with Average Glucose Level over the Preceding 5 Years
among Participants without Diabetes and Those with Diabetes.
Risk of Incident Dementia Associated with the Average Glucose Level during the Preceding 5
Years, According to the Presence or Absence of Diabetes.
Risk of Incident Dementia among Participants without and Those with Diabetes, According to
Glucose Values Averaged over the Preceding 5 Years and the Period between 5 and 8 Years
Earlier.
Results
During a median follow-up of 6.8 years.
dementia developed in 524 participants (74 with diabetes and
450 without).
including 450 of the 1724 participants who did not have
diabetes at the end of follow-up
(26.1%) .
74 of the 343 participants who had diabetes at the end of followup (21.6%).
- ‫ שפתחו דמנציה‬524 ‫מתוך‬
403 participants (19.5%) Alzheimer’s disease at the end of followup.
55 (2.7%) - had dementia from vascular disease,
66 (3.2%) -had dementia from other causes
Among participants without diabetes, higher average
glucose levels within the preceding 5 years were related to an
increased risk of dementia (P = 0.01); with a glucose level of
115 mg per deciliter (6.4 mmol per liter) as compared with 100
mg per deciliter (5.5 mmol per liter), the adjusted hazard ratio
for dementia was 1.18 (95% confidence interval [CI], 1.04 to
1.33).
Among participants with diabetes, higher average glucose
levels were also related to an increased risk of dementia (P =
0.002); with a glucose level of 190 mg per deciliter (10.5 mmol
per liter) as compared with 160 mg per deciliter (8.9 mmol per
liter),the adjusted hazard ratio was 1.40 (95% CI, 1.12 to 1.76).
-We found a monotonically increasing association between
the glucose level and the risk of dementia among people
without diabetes, which suggests that any incremental
increase in glucose levels is associated with an increased risk
of dementia .the same relationship between glycemia and
risk of dementia among people with diabetes at the higher end
of the range of glucose levels.
-inverse association between glucose level and risk of
dementia among people with diabetes who had relatively low
levels of glucose.
-We found that increased risk was associated with higher
glucose levels even at the lowest end of the glucose spectrum
among people who had not received a diagnosis of diabetes
Conclusions
Our results suggest that higher glucose levels
may be a risk factor for dementia,even among
persons without diabetes.